2021-11-15T16:37:05-06:00 2020-12-31 271728945 PKF O'CONNOR DAVIES LLP 500 MAMARONECK AVENUE HARRISON NY 105281633 990 2020-01-01 134034061 AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC AMST 2125753322 1060 AMSTERDAM AVENUE NEW YORK NY 10025 MARK PANCIRER SENIOR VP/CFO 2125753322 2021-11-15 1 MARK PANCIRER XXX-XX-XXXX GARRETT M HIGGINS P00543209 9143818900 2021-11-11 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z JAMES DAVIS 1060 AMSTERDAM AVENUE NEW YORK NY 10025 622786 0 X N/A X 1997 NY THE PURPOSES OF ACCHS INCLUDE THE PROVISION OF ADVISORY AND OTHER SUPPORT TO INDEPENDENT NOT-FOR-PROFIT ORGANIZATIONS DEVOTED TO THE PROVISION OF HEALTH CARE, HOUSING AND SERVICES TO THE ILL , THE IMPAIRED, THE DISABLED, AND THE ELDERLY. 11 11 2 11 0 0 323748 242830 291360 333811 92710 25145 -6844 1196 700974 602982 11103 10347 0 0 220416 143747 0 0 0 7036 76739 238555 230833 462419 372149 5427661 5776766 2289315 2267600 3138346 3509166 THE PURPOSES OF ACCHS INCLUDE THE PROVISION OF ADVISORY AND OTHER SUPPORT TO INDEPENDENT NOT-FOR-PROFIT ORGANIZATIONS DEVOTED TO THE PROVISION OF HEALTH CARE, HOUSING AND SERVICES TO THE ILL, THE IMPAIRED, THE DISABLED, AND THE ELDERLY. 0 0 154094 10347 333811 SUPPORT SERVICES TO RELATED FACILITY-BASED LONG-TERM CARE SERVICE PROVIDERS 154094 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 4 0 2 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X MARK PANCIRER 2125753322 1060 AMSTERDAM AVENUE NEW YORK NY 10025 JOSEPH C HOOPES JR CHAIRMAN & TREASURER 1.00 4.25 X X 0 0 0 FRANCES R OLIVIERI VICE CHAIRMAN 0.30 1.50 X X 0 0 0 GEORGE L VAN AMSON VICE CHAIRMAN 0.30 1.75 X X 0 0 0 JOSE V TORRES SECRETARY 0.30 0.80 X X 0 0 0 REV CANON JAMES CALLAWAY JR DIRECTOR 0.30 1.10 X 0 0 0 JAMES C CAMPBELL DIRECTOR 0.30 1.10 X 0 0 0 ISABEL M CARDEN DIRECTOR 0.30 1.10 X 0 0 0 R SCOTT EDMONDS DIRECTOR 0.30 1.10 X 0 0 0 DR KAREN M HOPKINS DIRECTOR 0.30 1.10 X 0 0 0 JAY H MCDOWELL DIRECTOR 0.30 1.35 X 0 0 0 LANGDON VAN NORDEN DIRECTOR 0.30 1.10 X 0 0 0 JAMES DAVIS PRESIDENT/ CEO 2.00 47.50 X 100667 584489 43492 MARK PANCIRER SR. VP. / CFO 0.50 49.50 X 30000 265631 42940 130667 850120 86432 1 0 1 0 0 98100 125655 19075 242830 MANAGEMENT SERVICES 561000 333811 333811 333811 25145 25145 21000 98100 19804 1196 1196 602982 333811 0 26341 X 10347 10347 130667 130667 13080 13080 1456 1456 34000 34000 3473 3473 291 291 433 433 1174 1174 ALLOCATED SALARIES 35912 35912 230833 154094 76739 0 247732 198262 4886562 4983785 146 140 121594 121594 171627 472985 5427661 5776766 21715 0 2267600 2267600 2289315 2267600 X 3138346 3509166 3138346 3509166 5427661 5776766 372149 -1329 0 X 0 0 0 X 216825 330261 295590 323748 242830 1409254 216825 330261 295590 323748 242830 1409254 582040 827214 83121 65922 78385 92710 25145 345283 1196 1196 1755733 1825860 0.47120 0.52640 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 INTEREST RECEIVABLES 43 DUE FROM RELATED PARTIES 447652 OTHER ASSETS 25290 472985 SUBVENTION - SUBORDINATE NOTE 2267600 2267600 ANNUAL GOLF OUTING 119100 98100 21000 16997 2807 119100 98100 21000 16997 2807 19804 1196 1 AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC 1060 AMSTERDAM AVENUE NEW YORK NY 10025 113711764 501(C)(3) 10347 GENERAL SUPPORT 1 0 PART I, LINE 2: THE HEALTH SYSTEM GAVE A CONTRIBUTION TO A RELATED ORGANIZATION, AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY, INC. THE ORGANIZATIONS HAVE THE SAME MANAGEMENT AND SIMILAR BOARDS, WHICH IS HOW THE HEALTH SYSTEM ENSURES THAT THE ORGANIZATION WILL USE THE FUNDS FOR THE INTENDED PURPOSE. THE HEALTH SYSTEM ALSO REQUIRES SUFFICIENT DOCUMENTATION FROM THE GRANTEE PRIOR TO REIMBURSEMENT OF EXPENDITURES. X X X 0 0 0 0 0 0 0 0 0 JAMES DAVIS PRESIDENT/ CEO 100667 575137 0 0 0 9352 0 13129 0 30363 100667 627981 0 0 MARK PANCIRER SR. VP. / CFO 30000 265087 0 0 0 544 0 13129 0 29811 30000 308571 0 0 FORM 990, PART VI, SECTION B, LINE 11B AMSTERDAM CONTINUING CARE HEALTH SYSTEM, INC. HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, A COPY OF THE FORM 990 IS PROVIDED TO AND REVIEWED BY THE AUDIT COMMITTEE. ANY ISSUES ARE REVIEWED AND CORRECTED. THE CFO THEN MAKES THE FULL 990 AVAILABLE TO ALL BOARD MEMBERS PRIOR TO FILING. ONCE THE BOARD HAS APPROVED THE RETURN IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS, AND KEY PERSONS MUST COMPLETE AN ANNUAL DISCLOSURE AND AFFIRMATION FORM IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY. AN INTERESTED DIRECTOR MEANS ANY AMSTERDAM DIRECTOR WHO HAS AN INTEREST AS A PRINCIPAL, PARTNER, DIRECTOR, OFFICER, EMPLOYEE, AGENT, OR STOCKHOLDER (OTHER THAN A STOCKHOLDER OF A PUBLICLY TRADED CORPORATION WHOSE STOCK IS WIDELY HELD) OF ANY ENTITY WITH WHICH AMSTERDAM HAS OR CONTEMPLATES TRANSACTING BUSINESS. AN INTERESTED DIRECTOR MUST DISCLOSE THE RELATIONSHIP OR INTEREST IN THE TRANSACTION TO THE BOARD OF DIRECTORS OF THE APPLICABLE AMSTERDAM ENTITY. DISCLOSURE SHALL BE MADE TO THE CHAIRMAN OF THE BOARD AS SOON AS THE INTERESTED DIRECTOR BECOMES AWARE OF THE POTENTIAL FOR A CONFLICT IN CONNECTION WITH THE TRANSACTION, WHO THEN SHALL INFORM THE APPLICABLE BOARD. IF THE CHAIRMAN IS INVOLVED IN THE TRANSACTION, THE CHAIRMAN SHALL ADVISE THE SECRETARY OF THE APPLICABLE AMSTERDAM ENTITY WHO SHALL ARRANGE FOR BOARD DISCLOSURE. NO INTERESTED DIRECTOR SHALL PARTICIPATE IN THE DISCUSSION, DELIBERATIONS AND VOTING REGARDING A TRANSACTION. THE AFFIRMATIVE VOTE OF THE MAJORITY OF ALL THE DIRECTORS OF THE APPLICABLE AMSTERDAM ENTITY SHALL BE REQUIRED BEFORE ENTERING INTO THE TRANSACTION (EXCLUDED IN SUCH COUNTS IS THE INTERESTED DIRECTOR). NO TRANSACTION SHALL BE INVALIDATED OR AFFECTED IN ANY WAY IF THIS POLICY IS FOLLOWED. ALL OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS OR SOONER IF A POTENTIAL CONFLICT OR ACTUAL CONFLICT SHOULD ARISE. POTENTIAL CONFLICTS OR ACTUAL CONFLICTS ARE REVIEWED BY THE CHIEF COMPLIANCE OFFICER OF AMSTERDAM NURSING HOME. FORM 990, PART VI, SECTION B, LINE 15 ACCHS HAS A PROCESS TO DETERMINE COMPENSATION FOR THE PRESIDENT/CEO WHICH INCLUDES A REVIEW BY A COMPENSATION COMMITTEE, AND OUTSIDE BENEFITS CONSULTANT, AND THE USE OF COMPARABLE DATA. THIS PROCESS INCLUDES A REVIEW OF TOTAL COMPENSATION INCLUDING BONUS CONSIDERATION BY THE COMMITTEE. THE DELIBERATIONS AND DECISIONS ARE DOCUMENTED WITHIN THE COMMITTEE MINUTES. THIS PROCESS WAS UNDERTAKEN IN SEPTEMBER 2019 FOR THE YEAR 2020. ACCHS HAS A PROCESS TO DETERMINE COMPENSATION FOR OFFICERS, WHICH INCLUDES A REVIEW BY A COMPENSATION AND BENEFITS CONSULTANT, AND THE USE OF COMPARABLE DATA. THIS PROCESS INCLUDES A REVIEW OF TOTAL COMPENSATION INCLUDING BONUS CONSIDERATION BY THE COMMITTEE. THE DELIBERATIONS AND DECISIONS ARE DOCUMENTED WITHIN THE COMMITTEE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN 2020. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AND FORM 1023 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS ALSO POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. FORM 990, PART IX, LINE 11G CONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 34,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,000. AMSTERDAM CONSULTING LLC 1060 AMSTERDAM AVE NEW YORK NY 10025 262979244 ADMIN & CONSULTING NY 352832 3910530 AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC AMSTERDAM SERVICES CORP 1060 AMSTERDAM AVE NEW YORK NY 10025 133902473 ADMIN & CONSULTING NY 501(C)(3) PF AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC 1 AMSTERDAM NURSING HOME CORPORATION (1992) 1060 AMSTERDAM AVE NEW YORK NY 10025 133834710 NURSING HOME NY 501(C)(3) LINE 10 AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC 1 AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC 300 EAST OVERLOOK PORT WASHINGTON NY 11050 113711764 ASSIST ELDERLY NY 501(C)(3) LINE 12A, I AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC 1 ANH FOUNDATION 1060 AMSTERDAM AVE NEW YORK NY 10025 137099598 GRANTMAKING NY 501(C)(3) PF AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC 1 AMSTERDAM 2012 INC 1060 AMSTERDAM AVE NEW YORK NY 10025 461715083 DEV RENT PROP NY 501(C)(3) LINE 10 AMSTERDAM NURSING HOME CORPORATION (1992) 0 AMSTERDAM SERVICES CORP (2001) 1060 AMSTERDAM AVE NEW YORK NY 10025 134184082 ADMIN & CONSULTING NY AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC C 1760 15158 1.00000 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 ANH FOUNDATION C 125655 COST AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC Q 200871 COST